A COMPARATIVE STUDY AMONG GENERAL ANAESTHESIA, CONTINUOUS THORACIC PARAVERTEBRAL BLOCK, AND THEIR COMBINATION IN PATIENTS UNDERGOING BREAST CANCER SURGERY

Abstract

Background: Thoracic paravertebral block (TPVB) is used as complete and effective way for biopsy and even mastectomy operations as it causes postoperative analgesia for many hours.Objective: the aim of this study was a comparison among general anaesthesia, continuous TPVB and their combination in female patients undergoing breast cancer surgery.Methods: This study was carried out on sixty female patients undergoing elective unilateral breast cancer surgery. The patients were randomly allocated into three equal groups (20 patients each) according to the applied anaesthetic technique, group I (general anesthesia group), group II (continuous TPVB) and group III (combined continuous TPVB and GA).Results: Immediately before and after skin incision, HR in group II & III was highly significant less than in group I. Immediate after skin incision and before emergence from OR, MAP in group II and III was significantly lower than in group I. Time spent in OR was significantly higher in group III than the other 2 groups and it was significantly higher in group II than in group I. VAS values at immediate post operative, 2h, 4h, 6hs, 12h, 18h and 24hs were highly significant less in group II and group III than in group I. The incidence of PONV was significantly less in group II and III than in group I. The overall incidence of the post operative complications was a significantly less in group II and III than in group I. Patient satisfaction was significantly higher in group I and group III than in group II. The durations of hospital stay were highly significant shorter in group II and III hospital than in group I. There were no significant difference between group II and III as regard hospital stay. In conclusion, this study revealed that, the TPVB whether alone or in combination with GA provides better postoperative pain control with little adverse effects compared with GA alone.Key Words: Ultrasound, thoracic paravertebral block, general anaesthesia, breast cancer